Change of scenery in pharmacies by politics and e-commerce

Contents

History of pharmacies

Basic principles in the branch of German pharmacies
1. regulative framework
2. political dimensions
3. health care market
4. sales trend
5. structure of pharmacies
6. job market in pharmacies
7. value Added Tax in the EU
8. discount contracts

Trends and tendencies of change in pharmacies

1.1 mail order business with drugs

1.2 0800 DocMorris.com

1.3 Mycare.de and other domestic pendants

1.4 Differences between traditional and discount pharmacies

1.5 Foresight

Review in other national systems

1.6 Urban clustering and accessibility concerns for rural areas

1.7 Be Aware of false expectations

History of pharmacies

Pharmacy is derivated from the Greek word “ pharmakon “ and designates the depository for drugs. The German synonym “Apotheke” is the Latin pronunciation and was needed in monasteries for the depositories.

The pharmacist or “ Apothecary ” is the health profession that links the health sciences with chemical sciences, and it is charged with ensuring the safe and effective use of medication (Wikipedia).

Pharmacy practise included some centuries ago traditional roles such as compounding and dispensing medications. The first pharmacy was opened in Trier/Germany in 1241 and is still working today. The development of pharmacies in Europe began to appear in the 12th century. Emperor Frederic II separated in his edict from Salerno in 1241 the professions physicians and pharmacists .Ownerships in or from pharmacies by physicians were no longer allowed. In the following times municipal profession codes were evolving. Till the 14th century pharmacists were retailer of drugs, condiments and medicinal plants. Apothecaries offered also tobacco and ingredients for medicines and other herbs not listed.

The knowledges of herbal and chemical ingredients are regarded as a precursor of modern sciences of chemistry and pharmacology. Apothecaries used their own measurement system, the apothecarie’s system, to provide precise weighing of small quantities. Apothecaries also were known to accept special requests for viles and poisons. With the beginning of the 14th century the pharmacists are changing from sellers of drugs and medicinal plants into producers of medicine. In the 17th and 18th century in the apothecaries not only medicines were produced, but also they are locations of applied research of drugs because of well grounded cognitions in chemistry. Apothecaries became often the ancestors of companies and later concerns like Dr.Oetker in Germany after developing its baking powder Backin.

As result of achievement of the pharmaceutical industry in the end of 19th and the beginning of 20th century , the pharmacies begin to change. Instead of self producing pharmaceuticals, more and more distribution, assay of quality and identity as well as advice will become the new spheres of pharmaceutical activities. After second world war the restrictions on the freedom of establishment were abolished in West-Germany, in the eastern part pharmacies were expropriated and health care system socialised like in other countries under soviet occupation.

Today the pharmacy as institution and organization are submitted lots of regulations and laws like German Pharmaceutical Act/Arzneimittelgesetz, work rules in pharmacies/ Apothekenbetriebsordnung and the Code of Social Law/ Sozialgesetzbuch. It is a fasten corset without many possibilities and modern business management. After job description and job related self understanding of pharmacists independent advising and care of patients should be the main focus and not the permanent bondage to sell more and skimming of profit by political decisions in accordance with health insurance funds simultaneously.

To meet with interests of conflict, the pricing of drugs only available with prescription was changed over to a charge fee. At the same time the legislator abolished the forbiddance to own more than one pharmacy in 2004. Since that time it is allowed to pharmacists to be owner till 3 branches. Furthermore that was hour of birth for many internet-and mail order pharmacies in Germany and the neighbour states. Momentary the European court debates whether an especially German law about interdiction to be owner of a pharmacy by persons who are not studied

pharmacists is confirm with the European freedom and right of establishment.

A decision will be expected in the first months of 2009. It would be the summit of much large-scale changes, who are rocking and shocking the market of community pharmacies. In large towns one discount pharmacy opens after the other, even though there are many pharmacies faced with ruin. Pharmacists have to detach themselves from tradition supposes the German professor Ziegenbein in his study of Pharmacie’s market in 2015. Experts in health have to become mercantilists, if they are interested to survive. ^[1]

After the opinion of the scientist there are three possibilities of success. The pharmacist can buy his store to a chain. In other case he has to cooperate with other pharmacies or wholesalers and industry. By all means he needs a potent alliance partner.

Today modern services like health care and clinical services with putting the main focus on safety and efficacy of medication come to the fore. Pharmacies in the cities or in the country, totally ca. 21.500 with more than 4 Million customer contacts everyday, are the most frequented group within the public health care system.

Basic principles in the branch of German pharmacies

1. regulative framework

In consideration of the fact, that pharmacies accept a sociopolitical public bid, namely the maintenance of the population with drugs, each individual little business is more controlled and regulated than all the other members of yellow pages by different laws and orders. First you can name the rules of work or the German term Apothekenbetriebsordnung. ^[2] This collection of ordinance embodies every personal, factual and housekeeping requirement in the daily work of the Pharmacist. You can find here

demands in the equipment, schooling and training of members of staff, the store-keeping as well acceptation as dispensing modalities of drugs and since 2004 how to handle the mail order business. I will list some essential aspects from the rules of work you must know for comprehension and understanding of the branch and of each business.

A pharmacy is obligated to be open over 24 hours to guarantee the pharmaceutical supply of population. Exception is possible, if another pharmacy within a defined district holds up the readiness to help. There are other exceptions for Sundays and bank holidays.

Because of ensuring the permanent opening, pharmacies are committed to have a night service. For organize such a service, pharmacies can conclude in regional groups from 2 -20 , depending on whether you live in the country, on an island or large towns. These pharmacies have to draw up a plan, from which for every day in the year everybody is possible to be aware one pharmacy open to the public.

German regulations include the obligation for the pharmacist to be present in the pharmacy, where they assume final responsibility. Only in exceptional circumstances (illness, holidays, etc.) may the pharmacist be absent for a three-month period every year. Likewise, the pharmacist who takes final responsibility has the right to undertake additional activities, as long as this does not prevent them from fulfilling their obligations in the pharmacy. They are prohibited from undertaking any other activity that is incompatible with the standards of the profession.

The pharmacy owner must be a qualified pharmacist. This principle guarantees the proper pharmaceutical supply of the population. If outside and multiple ownership became legal, the supply with pharmaceutical drugs would become dependent on purely commercial interests. Furthermore, oligopolies in the form of pharmacy chains that are subject to the financial aims of their shareholders would not generate any economic savings.

Authorisation to open a pharmacy is issued by the competent authority of the regional government.(Länder) There a no more geographical distribution criteria to regulate the opening of a new pharmacy. Neither are there any restrictions with respect to the sale of pharmacies, thus the transfer is unrestricted, the only condition being that the buyer is another qualified pharmacist.

Every pharmacy must have a laboratory in which products are monitored. There can only be conducted certain types of simple analyses by pharmacists like pregnancy tests, blood pressure, the taking of blood and urine samples.

Pharmacies can dispense medicines and other health-related products. They do not however have the exclusive rights to dispense medicines, as vets can also sell medicines for animals under their treatment, and certain medicines can be sold in centres other than pharmacies. The advertising of prescribed medicines and pharmacies is strictly forbidden.

On the other hand, the advertising of pharmaceutical specialities is permitted in all communication media, as well as prescribed lifestyle and chronic medicines. In the moment there is a situation where many initiators often are offending against valid law and apologize with merchandise prescriptions by the European community. They try to set the ball rolling and to cancel national laws, politic is still watching and doubtful or not interested.

There are no restrictions on pharmacy owners transferring their business to another place. Neither is there any compulsory retirement age for the pharmacist.

One can find two types of medicine in Germany : those with prescription, which depend on their active principle and are classified in accordance with their dosage, presentation or applications; and those available without a prescription which, in often cases, can be sold in places other than the pharmacies. Totally we have a split of near 80% with prescription and the other 20% are without, one half each from this part in pharmacies and in other stores.

Pharmacists are free-lance persons, only private partnerships or companies are allowed. Owners are liable with his entire private property.

But free-lance persons have not to pay trade income tax in Germany, only the pharmacists because they are working in a salesroom.

2. Political dimensions

Abbildung in dieser Leseprobe nicht enthalten

For understanding the legislative procedure and the reforming acts with respect to the German pharmacies within the health care reforms of the last years, you have to penetrate a certain socio-political chain of cause.

The health insurance funds or GKV had to pay last year 25.592 Millions or 70% of the total turnover of the pharmacies. This is an important part of expenditure of GKV. ^[3] The insurance funds are financing themselves by the dues of the state social insurance, resultant in kind of extraordinary non-wage costs. For population’s feeling these costs are parafiscal taxes and thus an everlasting, political theme.

There was no political group in the last years , be they government or opposition, this thematic pertains everyone equally and everybody of this politicians promised to lower the non-wage costs awaiting more popularity. Everybody is allergic to propose higher fees in consideration of always short of money. Because of the federal system in Germany over and over is election campaign. It is better and opportune to discuss and conclude taking measures in respect to lower the fees, all over comparably popular. Conflicts among each other are not to avoid. As you can se in the graphic, most medicines are with prescription and price-maintained.

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^[1].Prof.Dr.Ralph Ziegenbein, MBA Pharma Management

^[2].Apothekenbetriebsordnung=collection of ordinance in pharmacies

^[3].ABDA, association of German pharmacies